From drug pricing reforms to tariffs, the full impact of the Trump Administration on the pharmaceutical industry is not yet clear, but agility is the competitive advantage. Companies are facing compliance risks, competition from generics, and cost management issues, but also have opportunities to boost their bottom line through personalized medicine and digital health technologies. By reframing priorities, pharma can continue to innovate, grow new markets, and ensure patient access.  

Untapped market potential  

There are significant market opportunities in the U.S. that would bolster revenue if a broader patient and conditions lens was used. Most medical conditions occur in both men and women but many, like cardiovascular disease, affect women differently, yet they are treated the same way. A Women’s Health Access Matters report released in January highlighted that investing $350M in women’s health conditions could produce $14B in returns. The report also noted that doubling investment in women-focused research for coronary artery disease alone could save nearly $2B in healthcare costs.  

 Unlocking new markets requires reassessing existing data to drive innovation. Analyses should include a review of claims, payer, and patient-reported outcome data, by geography, to reveal potential market opportunities. By tapping into these gaps, pharma companies can advance growth while also improving health.   

Partnerships over lobbying 

In the wake of the Administration’s decision to drop the proposed expansion of weight-loss drug coverage for Medicaid and Medicare programs, the pharmaceutical sector must shift its focus from traditional lobbying efforts to building robust partnerships. Rather than relying on federal policy change, companies should prioritize collaboration with state programs, hospital networks, and insurers to maintain access to essential medications and preserve their market share. 

Eli Lilly’s direct-to-consumer site, LillyDirect, has agreements with telehealth providers Ro, LifeMD, and Teladoc Health to increase accessibility to weight-loss drug Zepbound for patients enrolled in weight loss management programs. Pursuing such partnerships benefits patients, providers, and pharma companies. 

Determining who to partner with requires a tailored approach combining data and engagement while understanding the needs of the patient communities they are seeking to reach. Regional collaborations reduce dependence on federal funding and align with the Administration’s emphasis on state autonomy and private enterprise. Through such partnerships, companies can drive innovation with an eye toward accessing new populations and help ensure long-term revenue growth. 

Outcomes-based approach 

Market expansion is challenging when improving access requires affordability. Alternative pricing models have been effective in increasing access to medications. Some companies, Novartis, Sanofi, and Johnson & Johnson among them, have explored or implemented value-based pricing models, which align pricing with the clinical benefit. The partnership agreements are tied to patient outcomes, resulting in lower costs and greater access. By focusing on drug efficacy, companies will have real-world data to measure patient impact.  

A business-driven, patient-centered approach, with state and private partnerships, can help pharma companies navigate the still unfolding regulatory environment with less financial and reputational risk. If the industry can proactively demonstrate prioritization of access and comprehensive data collection and measurement, while individually driving innovation, economic growth and long-term patient outcomes, there will be wins for the bottom line and the mission.